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CDC recommends boosters for Johnson & Johnson: What to know

People who received Johnson & Johnson can get any of the three available vaccines, per the CDC and FDA.

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For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

The US Centers for Disease Control and Prevention recommended booster shots for all recipients of Johnson & Johnson's coronavirus vaccine Thursday night, saying everyone who got the one-dose shot can get another dose of Johnson & Johnson at least two months after they were vaccinated-- or a booster shot of Pfizer or Moderna. 

The official recommendation followed a lengthy discussion by the CDC's independent advisory committee, with members discussing guidance on who should receive boosters of Moderna's and Johnson & Johnson's COVID-19 vaccines, which received the US Food and Drug Administration's authorization this week. The FDA also authorized a heterologous booster dose for all adults who qualify for one, meaning people can now "mix and match" vaccines for a booster. 

Read more: FDA officially authorizes mixing COVID boosters: What to know

Fewer people have gotten Johnson & Johnson's one-dose vaccine than Pfizer or Moderna. About 15 million people have been vaccinated with J&J, according to the CDC, a small number compared with those vaccinated with Pfizer or Moderna. This is partly because it was available in the US later than both mRNA vaccines, production issues resulted in millions of wasted doses and use was paused briefly in April after concerns over a link to a rare but serious blood clotting disorder (mostly in women under age 50) that isn't seen with the mRNA vaccines. 

People who received Moderna or Pfizer's COVID-19 vaccines are eligible for a booster if they're an adult at risk of severe COVID-19, either because of their age, underlying medical condition or where they live or work. The fact that boosters are recommended for all people who got Johnson & Johnson is based on research showing it's less effective than Pfizer and Moderna, with some experts arguing Johnson & Johnson should've been a two-dose series from the beginning. 

Those who got the one-dose J&J vaccine, including immunocompromised people, were initially left out of the country's booster shot plans because of a lack of data on the one-dose vaccine. The booster rollout in general is a controversial one -- members of the World Health Organization have called on countries such as the US to slow the process of giving booster doses to people who are already vaccinated because much of the world remains unvaccinated against COVID-19. As few as 3% of people in low-income countries have had a coronavirus vaccine, according to Our World in Data.

Even as the CDC recommends boosters for a large swath of vaccinated adults in the US, all three COVID-19 vaccines remain protective against severe disease and death. Before the CDC's official recommendation, some committee members argued we're losing sight of what a vaccine is designed to do, which is not to prevent all infections, but to protect against severe disease. 

As the booster campaign rolls on, here's what to know if you qualify for a booster because you got the J&J. 

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The definition of "fully vaccinated" hasn't changed. You're considered fully vaccinated after two doses of Moderna's or Pfizer's vaccine, or one dose of Johnson & Johnson's.

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Does it have to be another shot of J&J?

You can get any of the three COVID-19 vaccines available, meaning your choice can depend on your personal circumstances or preference. Both Johnson & Johnson's and Pfizer's booster is the same dose as the original series, while Moderna's booster is a smaller dose than its original series. 

However, some committee members expressed concerns over recommending a second dose of Johnson & Johnson to women under age 50, who are at a higher risk for the very rare but also very serious blood clotting disorder associated with the vaccine (these clots require different treatment than the clots that occur from things such as taking birth control pills or riding on an airplane). 

Importantly, this risk isn't associated with Pfizer or Moderna's vaccine. There is also the rare risk of a neurological disorder linked to Johnson & Johnson, occurring mostly in older men. 

In general, the lack of safety data for a second dose of J&J in groups at-risk for those rare side effects steered committee members away from a direct recommendation for the same vaccine. CDC committee member Dr. Pablo Sanchez, said that while he agrees people who received Johnson & Johnson should get a second dose, "I would prefer that those individuals get an mRNA vaccine," he said. 

The bottom line from the CDC's advisory committee was that allowing more freedom in which COVID-19 vaccine people can receive as a booster puts the final decision in the hands of the individual, both on what booster they receive or whether they need one at all. 

If you decide you need a booster and you're either unsure of what vaccine you should receive, or want to know more about what "mixing and matching" entails, talk with your doctor or other health care provider. 

Although data on "mixing vaccines" in the US is limited, it's been done for months in Europe, where individuals have received a dose of AstraZeneca (a viral vector vaccine like Johnson & Johnson) combined with a dose of mRNA vaccine. 

What if I'm immunocompromised and got J&J? 

Although very few immunocompromised people likely received Johnson & Johnson compared to Moderna or Pfizer, a CDC committee member said, they're out there and they were neglected in the CDC's initial recommendation for an extra dose for moderately or severely immunocompromised folks. (Immunocompromised people were eligible for COVID-19 vaccines before the general public, which means they likely got Moderna or Pfizer, which were available sooner in the pandemic). 

Right now, immunocompromised people who got J&J should follow the same recommendation for everyone else who got Johnson & Johnson, according to the CDC. Meaning they can choose a booster from any of the three vaccine-makers. 

When can I get a booster? 

At least two months after your original vaccination, per the recommendation. With the FDA authorization and official CDC recommendation, most pharmacies, clinics and doctor's offices should be able to give out boosters, depending on what they have in stock, of course. 

Getting an original series of any COVID-19 vaccine remains the best thing people can do to protect against severe COVID-19 disease. Unvaccinated people are more than 10 times more likely to be hospitalized with or die from COVID-19 than fully vaccinated people, according to the CDC. About 21% of US adults haven't received a COVID-19 shot

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.